Varicella Vaccination – Chickenpox Vaccine Guide
The varicella vaccination protects against chickenpox, a highly contagious viral disease. It is recommended for children and certain at-risk groups by health authorities worldwide.
Things worth knowing about "Varicella Vaccination"
The varicella vaccination protects against chickenpox, a highly contagious viral disease. It is recommended for children and certain at-risk groups by health authorities worldwide.
What Is the Varicella Vaccination?
The varicella vaccination is a preventive immunization against varicella, commonly known as chickenpox. Chickenpox is caused by the Varicella-Zoster Virus (VZV) and is one of the most contagious infectious diseases known. The vaccine is designed to prevent infection or significantly reduce the severity of the disease in vaccinated individuals.
Why Is the Vaccination Important?
While chickenpox is typically mild in healthy children, it can cause serious complications in infants, adults, pregnant women, and immunocompromised individuals. Potential complications include bacterial superinfections of the skin, pneumonia, encephalitis, and severe disease in newborns.
Importantly, after primary infection, the virus remains dormant in the nervous system for life and can reactivate later as shingles (Herpes zoster). Vaccination significantly reduces this long-term risk.
Vaccination Recommendations
Major health authorities, including the World Health Organization (WHO) and national immunization programs, recommend the varicella vaccine for the following groups:
- All children starting at 12 months of age: two doses with a minimum interval of 4-6 weeks
- Unvaccinated children and adolescents (catch-up vaccination)
- Seronegative women of childbearing age (no prior immunity)
- Seronegative individuals in close contact with immunocompromised persons
- Seronegative individuals with certain underlying conditions (e.g., severe atopic dermatitis, HIV infection)
- Seronegative healthcare and medical workers
Available Vaccines
The varicella vaccine is a live attenuated vaccine based on a weakened strain of the Varicella-Zoster Virus. Well-known products include Varilrix and Varivax. A combination vaccine offering simultaneous protection against measles, mumps, rubella, and varicella (MMRV vaccine, e.g., Priorix-Tetra or ProQuad) is also available.
Vaccination Schedule and Dosage
Two doses are required to ensure reliable protection:
- First dose: At or after 12 months of age (recommended between 12-15 months)
- Second dose: At least 4-6 weeks after the first dose (recommended between 15-23 months)
When the MMRV combination vaccine is used for the first dose in children aged 12-14 months, a slightly increased risk of febrile seizures has been observed. Some national guidelines therefore recommend administering the first dose as separate MMR and varicella vaccines, with the second dose given as the MMRV combination.
Efficacy and Protection
After complete immunization with two doses, the vaccine efficacy against varicella disease exceeds 95%. In cases where vaccinated individuals do contract chickenpox (known as breakthrough infection), the illness is typically much milder, with fewer lesions and a shorter duration.
Possible Side Effects
The varicella vaccine is generally well tolerated. Possible side effects include:
- Local reactions at the injection site (redness, swelling, pain)
- General symptoms such as mild fever or fatigue
- In rare cases, a mild, non-contagious measles-like or chickenpox-like rash (so-called vaccine varicella) within 2-4 weeks of vaccination
- Very rarely: shingles caused by the vaccine virus strain (far less common than after natural infection)
Contraindications
The vaccine should not be administered to individuals with:
- Severe immunodeficiency (e.g., severe combined immunodeficiency, high-dose immunosuppressive therapy)
- Pregnancy (pregnancy should be avoided for 4 weeks following vaccination)
- Severe hypersensitivity to any component of the vaccine
- Acute severe illness with high fever
References
- World Health Organization (WHO): Varicella and Herpes Zoster Vaccines - WHO Position Paper. Weekly Epidemiological Record, 2014;89(25):265-288. www.who.int
- Robert Koch-Institut (RKI) - Standing Committee on Vaccination (STIKO): Recommendations on varicella vaccination. Epidemiologisches Bulletin, current edition. www.rki.de
- Heininger U, Seward JF: Varicella. Lancet. 2006;368(9544):1365-1376.
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